ISHRS Conference: Follicular Unit Extraction Review

by Kevin Rands | May 15, 2016 5:18 am

Discussion on the new Hair Transplant technique known as Follicular Unit Extraction, and the importance of proper scientific method, disclosure, and peer review due to the high potential for complications, and ethical reasons.

ISHRS Conference: Discussion on the new Hair Transplant technique known as Follicular Unit Extraction, and the importance of proper scientific method, disclosure, and peer review due to the high potential for complications, and ethical reasons.Direct Follicular Unit Extraction

Authors: William Rassman, MD; Robert Bernstein, MD; Robert McClellan, MD; Roy Jones, MD

This is an interim report to update medical practitioners in the field on the promise and the problems involved in direct follicular extraction. Prior to this presentation, there has been no medical literature to document that any practitioner has successfully mastered the critical problems in implementing such a procedure. The purpose of this presentation will be to share with the experts in the field our experience with this exciting technique and to evaluate the risks and benefits that we have observed thus far. We welcome the participation of hair restoration practitioners and would be pleased to respond to your questions, comments and suggestions.

Over the past 4 years, we have explored extracting follicular units directly from the donor area with punches ranging from 1.0mm to 1.5mm in diameter using the open donor technique. The focus of our investigation was in the following areas:

1. Harvesting efficiencies with hand and motorized punches, ranging in size from 1.00mm-1.5mm
2. Wound healing
3. Residual donor Scarring
4. Patient comfort when compared with conventional excisional harvesting techniques
5. Systems for implementing direct follicular unit extraction to maximize the quantity and quality of grafts
6. Instrument development for maximizing donor yield with direct follicular unit extraction
7. The ability to immediate graft placement to prevent telogen effluvium (a recent area of interest)
8. The marketing value of avoiding a donor scar
9. A perspective on this technique in the evolving field of follicular unit transplantation

We are concerned that the premature adaptation of this technique, before it is open to scrutiny by the medical community [The Woods Procedure] poses potential problems for patients and physicians. The potential risks and benefits of this procedure are not yet defined and we emphasize to the profession that there are ethical problems associated with using this technique prematurely. There may also be problems with obtaining adequate informed consent from patients if important elements of a procedure are not disclosed.

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